To be so annoyed with bloody paternalistic NHS

It sounds like you had a tough time with surgery. I'm sorry to hear that.
I was agreeing with you, all surgery has risk some more than others.
Yes tubal ligation has higher risk than vasectomy in most cases, but not if the man has health issues that make a vasectomy dangerous and the woman is healthy. Each person or couple need to weigh up their own risks and needs.
The OP suggested she wanted a hysterectomy, I suggested considering having tubal ligation, as a less invasive surgery. Just an option for them to consider.

So your laproscopic surgery was easy, while I was in agony thanks to the Co2. Um, great?

That has nothing to do with my point, which was that it carries far more risk than vasectomy, as it involves cutting into the abdomen, that it can be very painful or go wrong (with infection), and that it isn’t comparable to non-invasive options.
Certainly, having one's husband get a vasectomy is less risky and more effective than laproscopic tubal ligation, if the goal is preventing pregnancy.

The fact that you personally stopped for coffee on the way home is irrelevant to those things.

All surgery has risk, some more than others. From experience having tubal ligation had minimal recovery time. We went for a coffee on the way home from mine.

I have a lot of sympathy with you, OP, but given the number of women who say their pregnancy is due to contraceptive failure, I can understand why they take the line that they do.

Incidentally, one of my oldest friends (we are in our 60s) had debilitating migraines for years. It is now under control for the first time due to Botox. Because she has it for medical reasons it is paid for by the NHS.

It might be worth enquiring whether that is an option for you.

My niece was not prescribed Roaccutane due to possible pregnancies. She is a lesbian who has never had, nor ever would have, sex with a man.

That is completely wrong. Check the Nice guidelines. I’m 49 and have only just come off the combined Pill. My (female) GP has always said I can stay on the Pill till 50 and move straight to HRT. Another friend has been on the mini pill till late 40s. i don’t know anything about migraines sorry and it looks like others are giving better advice about those. Maybe you’re not supposed to take the Pill with migraines? (Clutching at straws - I’d be livid at that GP)

You're entitled to be hypocritical if you like, but being so in such a blatant manner makes your entire argument discardable. You clearly aren't arguing from a position of rationality.

For most of history women have drunk alcohol during pregnancy. I drank a glass a week because it was the 80s and drinking wine - or alcohol of any sort - every day or every night was not a thing. It was a Friday night treat - because wine was relatively expensive compared with wages. Also, I have kept a diary since 1975 and what did will be in it - I tell my diary the truth (pointless otherwise to keep it) - so I could (I won't, real hassle of unpacking boxes) look up exactly what I did during both pregnancies. A small glass of wine (125ml) a week was the recommendation for alcohol during pregnancy at the time. When I became pregnant (much wanted child) my GP suggested opening bottle of champagne btw - he did not suggest I should not have any!
Yes, if you know about your condition you can talk about medication, but it is stil your GP making sure it is safe for you, not you.
I don't see any connection between social drinking among fertile women and deliberately taking teratogenic medicine - I remember thalidomide (and in the 80s took nothing to stop morning sickness or any other problem during pregnancy - doctors would not prescribe such things, either - tea and dry biscuits works well). Migraine I took to bed in a dark room, having had sweet tea - and practised relaxation techniques.
Foolish women drink to excess - we cannot legislate for every foolish thing people do.

Just to say, going on to high dose HRT patch has ended my migraines and I have not had a single headache

My private meno constant explained my migraine was caused by hormone levels changing upland down
So the higher dose keeps them stable?

It's like a minor miracle for me...

Most people I know who deal with chronic or less common health conditions do tell their GP what they want, because usually they are actually more well-informed on that one niche subject - and new medications and treatments - than their doctor. The doctor then uses their medical knowledge to check the validity of the patients' suggestions, before going ahead with what the patient wants.

As for alcohol, there is no known safe amount of alcohol to drink while pregnant. And of course, while you said you only drank one small glass a week, you could have been lying - after all, how can you be trusted not to drink a bottle a day while pregnant? Or, what if a woman drinks heavily before she even realises she's pregnant at 4, 6, or even 8 weeks? The risk of fetal alcohol syndrome, a life long disability, could be quite high.

So unless you'd like to be hypocritical, either women should be banned from drinking alcohol, or, fertile women should be allowed to take teratogenic medications so long as they understand the risks, declare they understand they will need to abort any pregnancy, and have a solid contraceptive plan of some sort (whether it's their husband's vasectomy, or the pill.)

You have my point upside down. Yes, the doctor can recommend and offer a choice of possible treatments with their side-effects. But the patient only gets to choose from those on offer, not ones the doctors is certain will harm. A second opinion might or might not uphold the patient's desired view.
All I am saying is that medicines are not a pick and mix we can choose from. We have to take our doctor's advice. In OP's case the doctor said it was not safe to take the medication because she might become pregnant. And he knows that's possible even if it means an abortion, and that puts the patient at risk, and it's a risk the doctor (and the NHS) considers to be one not worth taking.
I understand migraine. I used to have the sort that start with an aural aura and progressed to blinding pain, disorientation, inability to do anything, see properly, and frightening aphasia, and which not even prescribed pain killers touched. I sympathise with the OP on that front. But I think 'bloody paternalistic' is an unrealistic description of what her GP is trying to tell her.

Interesting point. And I did not say anything like that, but that a doctor is the one who prescribes, patients do not tell the doctor what they want - because usually they have no relevant or well-understood medical knowledge.
I drank through both my successful pregnancies in moderation (probably a smal glass of wine a week). Both DC fine, intelligent and focused. I think the suggestion women of child bearing age should not drink at all is utter bollocks, btw.

Do you think you are taking too many meds for your migraine? Perhaps try another pain control method, such as TENS? Sometimes pain killers can have the opposite effect, especially if you mix them.

My consultant explained that the brain can really only take one pain message at a time, and to try to distract with another feeling that can be controlled. It works with me, though I haven't had a migraine for years. I have other pain instead.

Why not ask for an appointment with the PAIN CLINIC who are expert in pain control?

I'm pretty sure they are still allowed to do that.
I know someone who has a really extreme medication that would definitely cause birth defects - other people can't even risk touching the stuff without gloves on! - and she had to sign a similar waiver.

I disagree. They can recommend medication as advised by the guidelines and lay out the risks and benefits, but it's the patient's decision whether or not to take it, and we can ask for second opinions if we don't agree. One doctor's word is not law. And as for "based on his knowledge of patient" - in this case, he knows that the OP would have to terminate a pregnancy anyway, so it's a very poor risk assessment to say she can't have the medication without being on contraception. There's not going to be any baby.

I have seen my GPs look things up on Wikipedia before. I have indeed, at times, known more about a particular medication than my GP because they are not all-knowing gods, and given how busy they are and the fact that they don't specialise, they won't be up to date with absolutely everything that's happening in the medical world.

So yes, they should listen to their patients, and if the patient is well-informed, has tried every other option, and - at the end of their tether - wishes to trial a slightly riskier medication, a good GP should allow that.

GPs also differ in their recommendations. My GP for instance, has initially refused to prescribe me the combined contraceptive pill because I am late 30s, and smoked in my 20s - otherwise I'm slim, in perfect health, and have no other contraindications. People on this very thread have said their GP will prescribe the pill into their late 40s/early 50s!

I didn't push my GP for the pill at the time I last saw her, as I don't really need it right now, but I may do in the future and she should - if she's a good GP - say yes, knowing that I'm fully informed of the risks and know what symptoms to be alert for.

The risk they are trying to avoid here is a child with birth defects.
OP has stated she cannot carry a pregnancy to term.
If she became pregnant while not taking the medication, there would be no child.
If she became pregnant while taking the medication, there would be no child.
So she is being denied medication she needs "just in case" of something which cannot happen.

@Grammarnut's comments made me think of that too!

That kind of logic leads to the notion that women under the age of 55 who haven't had her ovaries and/or uterus removed (because any other method can fail!) shouldn't be allowed to drink, smoke, or indeed take ibuprofen or any other medications, teas, or foods that could cause harm to a foetus, should they somehow fall pregnant.
Never mind the woman's actual, daily quality of life - it's all about the potential foetus's potential quality of life, should it be conceived and not aborted.

I never suggested any of that. Yes, negligence is a problem and the NHS should do more about it, frankly. But health care is not a bundle of options we can choose from. The UK is not the US where patients see drugs advertised and demand they be prescribed whether suitable or not. It is the doctor's job, based on his knowledge of patient, illness, taking a history etc to decide the medication - not the patient's. I know nothing about migraine medication (despite having taken such medication for years) and would not tell my doctor I should have x treatment - I am not a doctor and I don't know what risk I am taking, so I cannot rationally decide to take it.

The NHS has to protect itself against negligence. Costs are a factor, but they are not uniquely a higher factor when you are treating a women of childbearing age who may become an incubator to a foetus that may never exist, compared to a man. Women do not matter less than men and they should not be expected to accept a lower standard of treatment.

The NHS exposes itself to all sorts of costs all day long. When it suddenly decides in a case like this it is a bridge too far, but not for men (like pp’s example of the lorry driver, who may kill himself and others if he has an accident through medication-induced drowsiness) that is clear, rank misogyny.

It is not ok to neglect the person who is alive for a putative potential person who may never exist and who cannot exist outside of the woman’s body. Women with untreated migraine can suffer immensely and can be so disabled they are unable to work or take full part in society. That is not acceptable when there are effective treatments.

The NHS is meant to be offering patient-centred care. That means respecting a woman’s autonomy and accepting that it is for her to weigh up risk factors and benefits and what she is prepared to live with, not for a doctor who may see her for all of ten minutes and then can forget about her situation. She is the one who lives with the consequences, not the doctor. So the ultimate call has to be hers. It’s nothing to do with not being men, it’s about respecting patient autonomy, something we were meant to have had for decades, but still don’t, as the even NHS showed.

As mentioned upthread, the legal ramifications of this are solvable. Where there is a will. Clearly there is not, and the medics profession would prefer not to allow woman the same autonomy and treatment options they offer men. It’s just the same old, same old, we’ve had forever.

Infantilising women in this way is not ok.

Well, with slightly less transhuman nomenclamature, women's bodies are set up to build babies and we have to take this into account. NB I have never been refused medication because I might get pregnant, ever, and I think it's weird. However, I see the NHS's point. And we do not have full bodily autonomy - our bodies do what they want rather than what we want quite a lot of the time.
When I have had coils removed or put in I have never been asked if my (ex) DH agreed. I did however have to go to the consultation about my (ex) DH having a vasectomy. They wanted to be sure it was a mutual decision. Times seem to have got more misogynistic (unsurprising what with trans nonsense being taken as Stonewall gospel).

Does anyone remember that hilarious report from, I think WHO, which basically said, "women of childbearing age shouldn't drink at all in case they get pregnant"?
We're back there.

@NewCushions Shocking.
I am able to take hormonal contraceptives if I so wished at the age of 45. Like hell am I going to! My husband had to step up and have a vasectomy after our daughter was born (his only child).

Ridiculous. On that basis, a man who drives for a living should not be given strong painkillers as he might drive anyway and cause an accident and that will cost the NHS a fortune in the cost of his treatment, and the treatment of anyone he harms as a result.

All of thes risks, while legitimate, are not a reason to NOT give a woman medicine she needs.

I note that when my friend wanted to get her coil removed, the nurse didn't want to do it unless she had confirmation that her DH had agreed to this! Meanwhile, when DH went to get a vasectomy, they didn't care if I agreed ... on no, they didn't understand why he was getting a vasectomy when his wife (me) could have hormonal contracpetion instead (I can't).

It's all bullshit and it's all about women's bodies continuing to be seen purely as incubators.